Ratushnyi R. Prognostic model of endodontic complications of treatment in the ergonomics of the dentist

Given the widespread prevalence of endodontic pathology in Ukraine and the world, as well as the lack of success in the treatment and treatment of root canals, there is reason to believe that there is still a question of improving the quality of endodontic treatment. Sources of scientific and medical information indicate that there is a fairly high prevalence of caries in the country, and one of the most difficult complications in terms of treatment is pulpitis, the treatment of which requires significant time. In addition, the rate of progression of pulpitis may be individually different depending on the characteristics of the biochemical structure of dentin. Withdrawal of dental care from the primary level is gaining momentum. According to various data, the evaluation of the effectiveness of endodontic treatment is not more than 70%, due to objective and subjective factors: anatomy, individual characteristics, availability of the operative field, which in turn rests on ergonomics and technical characteristics of dentists. opportunity to conduct quality endodontic treatment. It is also worth noting the special importance of ergonomics of the dentist and its impact on the quality of endodontic treatment, because the development of complications during endodontic treatment directly affects the prognosis of the dentition. Unfortunately, the issue is poorly developed in Ukraine and there are no clear criteria for the impact of ergonomics of dentists on the quality of dental manipulations, which shaped our research objectives, due to the significant interest in systemic improvements in endodontics. High labor costs and difficult operational access require the adoption of awkward postures, which leads to rapid fatigue and the development of occupational diseases, which in turn impairs some treatments and the ability to work. The aim of the study was a clinical and experimental justification for optimizing the results of endodontic treatment by correcting ergonomic patterns of dentists on the basis of discrete­event modeling of the workflow. The goal was to solve a number of specific tasks, namely: 1. To establish indicators of prevalence of the main errors and complications made during endodontic treatment by retrospective analysis of dental radiographs and to determine the specifics of their distribution depending on the peculiarities of the work process. 2. To systematize the main deviations in the structure of the ergonomic pattern of work of dentists in the treatment of root canals, taking into account the expert criteria for quantification of the severity of identified ergonomic disorders. 3. To determine the severity of potential regression relationships between indicators of the frequency of errors and complications during endodontic treatment, and the distribution of parameters of compliance with generally accepted criteria for assessing the ergonomic components of the workflow. 4. To develop an algorithm for individualized correction of ergonomic pattern of dentists using the ability to model the spatial relationships of components in the projection of the working field and taking into account the topographic affiliation of different groups of teeth. 5. Evaluate the effectiveness of practical implementation of individualized protocols for the correction of ergonomic components in the process of endodontic treatment and changes in the structure of the distribution of errors and complications in terms of optimizing the ergonomic pattern according to adapted recommendations. Conclusions. The dissertation solves the problem of optimizing the results of root canal treatment by minimizing the risk of procedural errors and complications through the adaptation of ergonomic pattern components during endodontic interventions and individualization of preventive measures by identifying and eliminating problematic components of modeling.